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. 2024 Feb 20;24(1):161.
doi: 10.1186/s12909-024-05155-1.

An intelligent grasper to provide real-time force feedback to shorten the learning curve in laparoscopic training

Xuemei Huang #  1 , Pingping Wang #  1 , Jie Chen  1 , Yuxin Huang  1 , Qiongxiu Liao  1 , Yuting Huang  1 , Zhengyong Liu #  2 , Dongxian Peng #  3
Affiliations

An intelligent grasper to provide real-time force feedback to shorten the learning curve in laparoscopic training

Xuemei Huang et al. BMC Med Educ. .

Abstract

Background: A lack of force feedback in laparoscopic surgery often leads to a steep learning curve to the novices and traditional training system equipped with force feedback need a high educational cost. This study aimed to use a laparoscopic grasper providing force feedback in laparoscopic training which can assist in controlling of gripping forces and improve the learning processing of the novices.

Methods: Firstly, we conducted a pre-experiment to verify the role of force feedback in gripping operations and establish the safe gripping force threshold for the tasks. Following this, we proceeded with a four-week training program. Unlike the novices without feedback (Group A2), the novices receiving feedback (Group B2) underwent training that included force feedback. Finally, we completed a follow-up period without providing force feedback to assess the training effect under different conditions. Real-time force parameters were recorded and compared.

Results: In the pre-experiment, we set the gripping force threshold for the tasks based on the experienced surgeons' performance. This is reasonable as the experienced surgeons have obtained adequate skill of handling grasper. The thresholds for task 1, 2, and 3 were set as 0.731 N, 1.203 N and 0.938 N, respectively. With force feedback, the gripping force applied by the novices with feedback (Group B1) was lower than that of the novices without feedback (Group A1) (p < 0.005). During the training period, the Group B2 takes 6 trails to achieve gripping force of 0.635 N, which is lower than the threshold line, whereas the Group A2 needs 11 trails, meaning that the learning curve of Group B2 was significantly shorter than that of Group A2. Additionally, during the follow-up period, there was no significant decline in force learning, and Group B2 demonstrated better control of gripping operations. The training with force feedback received positive evaluations.

Conclusion: Our study shows that using a grasper providing force feedback in laparoscopic training can help to control the gripping force and shorten the learning curve. It is anticipated that the laparoscopic grasper equipped with FBG sensor is promising to provide force feedback during laparoscopic training, which ultimately shows great potential in laparoscopic surgery.

Keywords: Fiber Bragg grating; Force feedback; Laparoscopic training; Learning curve; Minimally invasive surgery.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Instrument connection diagram
Fig. 2
Fig. 2
Schematic flowchart of the study protocol
Fig. 3
Fig. 3
Box plots of the gripping force among novices for baseline assessment
Fig. 4
Fig. 4
(A) and (B) represent the learning curves of maximum force and standard deviation of the gripping force, respectively (SD, standard deviation)
Fig. 5
Fig. 5
Gripping force at different stages under various conditions. (a) The maximum gripping force of Group C, Group A2 and Group B2 during baseline assessment stage, training stage and follow-up stage, (b) the standard deviation of gripping force of Group C, Group A2 and Group B2 during these three stages
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